冠心病合并2型糖尿病患者血清HMGB1、hs-CRP与冠状动脉病变的相关性研究  

Study on the correlation between serum HMGB1,hs-CRP and coronary artery disease in patients with coronary heart disease complicated with type 2 diabetes mellitus

作　　者：吴蓉 邓云霞 唐湘宇[1] WU Rong;DENG Yunxia;TANG Xiangyu(Department of Cardiovascular Medicine,Loudi Central Hospital,Loudi,Hunan 417000,China)

机构地区：[1]娄底市中心医院心内科,湖南娄底417000

出　　处：《现代医药卫生》2024年第12期2007-2012,共6页Journal of Modern Medicine & Health

基　　金：湖南省娄底市中心医院项目(Y2022-09)。

摘　　要：目的 探讨冠心病合并2型糖尿病(CDM)患者血清高迁移率族蛋白B1(HMGB1)、超敏C反应蛋白(hs-CRP)水平与冠状动脉(冠脉)病变的相关性。方法 选取2021年6月至2022年9月在该院心内科住院行冠脉造影患者309例作为研究对象。根据是否诊断为冠心病、T2DM分为对照组[无冠心病及2型糖尿病(T2DM),82例]、冠心病组(75例)、T2DM组(50例)和CDM组(102例)。比较4组患者生化指标[包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等]及HMGB1、hs-CRP水平的差异。根据不同冠脉造影SYNTAX评分将CDM组分为低分组(<22分,29例)、中分组(22~33分,35例)和高分组(>33分,38例)。比较3组不同SYNTAX评分CDM患者HMGB1、hs-CRP水平,并分析其与冠脉病变的相关性。结果 4组患者性别、年龄、吸烟史、高血压病史、体重指数比较,差异均无统计学意义(P>0.05);CDM组患者TG、TC、LDL-C、hs-CRP、HMGB1水平均明显高于冠心病组、T2DM组及对照组,HDL-C水平均明显低于冠心病组、T2DM组及对照组,差异均有统计学意义(P<0.05)。3组不同SYNTAX评分CDM患者性别、年龄、吸烟史、高血压病史、体重指数比较,差异均无统计学意义(P>0.05);高分组患者TG、TC、LDL-C、HMGB1、hs-CRP水平均明显高于中分组及低分组,HDL-C水平均明显低于中分组及低分组,差异均有统计学意义(P<0.05)。HMGB1、hs-CRP水平与SYNTAX评分均呈正相关[相关系数(r)=0.455、0.449,P<0.05]。HMGB1与hs-CRP也呈正相关(r=0.282,P<0.05)。HMGB1、hs-CRP联合诊断CDM患者冠脉病变程度的受试者工作特征曲线下面积(0.873)均明显大于HMGB1、hs-CRP单独检测(分别为0.848、0.725)。结论 CDM患者体内存在更为严重的脂代谢紊乱与复杂的炎症反应,可能加速了冠脉病变的进展。CDM患者HMGB1、hs-CRP水平与SYNTAX评分均呈正相关,且二者联合检测可能对CDM患者冠脉病变的预测及诊断价值更高。Objective To investigate the correlation between serum high mobility group protein B1(HMGB1),high-sensitivity C-reactive protein(hs-CRP)levels and coronary arterylesions in patients with coronary heart disease and type 2 diabetes mellitus(CDM).Methods A total of 309 patients who underwent coronary angiography in the Department of Cardiology of this hospital from June 2021 to September 2022 were selected as the study subjects.According to the diagnosis of coronary heart disease and type 2 diabetes mellitus(T2DM),they were divided into control group(82 cases without coronary heart disease and T2DM),coronary heart disease(CHD)group(75 cases),T2DM group(50 cases)and combined CDM group(102 cases).The biochemical indexes[including total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),etc.]and the levels of HMGB1 and hs-CRP were compared among the four groups.According to different coronary angiography SYNTAX score,CDM group was divided into low score group(<22 points,29 cases),middle score group(22-33 points,35 cases)and high score group(>33 points,38 cases).The levels of HMGB1 and hs-CRP in CDM patients with different SYNTAX scores were compared among the three groups,and their correlation with coronary artery disease was analyzed.Results There were no significant differences in gender,age,smoking history,hypertension history,and body mass index(BMI)among four groups(P>0.05).The levels of TG,TC,LDL-C,hs-CRP,and HMGB1 in the CDM group were significantly higher than those in CHD group,T2DM group,and control group,and the levels of HDLC were significantly lower than those in CHD group,T2DM group and control group,the differences were statistically significant(P<0.05).There were no significant differences in gender,age,smoking history,hypertension history and body mass index among the three groups of CDM patients with different SYNTAX scores(P>0.05).The levels of TG,TC,LDLC,HMGB1 and hs-CRP in high score group were significantly higher than those in m

关 键 词：冠心病 2型糖尿病 合并症 炎症因子 SYNTAX评分 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]